Creat membership Creat membership
Sign in

Forgot password?

Confirm
  • Forgot password?
    Sign Up
  • Confirm
    Sign In
Creat membership Creat membership
Sign in

Forgot password?

Confirm
  • Forgot password?
    Sign Up
  • Confirm
    Sign In
Collection

toTop

If you have any feedback, Please follow the official account to submit feedback.

Turn on your phone and scan

home > search >

Improving the Reliability of Physician Performance Assessment Identifying the "Physician Effect" on Quality and Creating Composite Measures

Author:
Kaplan, Sherrie H.  Griffith, John L.  Price, Lori L.  Pawlson, L. Gregory  Greenfield, Sheldon  


Journal:
MEDICAL CARE


Issue Date:
2009


Abstract(summary):

Background: The proliferation of efforts to assess physician performance underscore the need to improve the reliability of physician-level quality measures. Objective: Using diabetes care as a model, to address 2 key issues in creating reliable physician-level quality performance scores: estimating the physician effect on quality and creating composite measures. Design: Retrospective longitudinal observational study. Subjects: A national sample of physicians (n=210) their patients with diabetes (n=7574) participating in the National Committee oil Quality Assurance-American Diabetes Association's Diabetes P vider Recognition Program. Measures: Using 11 diabetes process and intermediate outcome quality measures abstracted from the medical records of participants, we tested each measure for the magnitude of physician-level variation (the physician effect or "thumbprint"). We then combined measures with a Substantial physician effect into a composite, physician-level diabetes quality score and tested its reliability. Results: We identified the lowest target values for each Outcome measure for which there was a recognizable "physician thumbprint" (ie, intraclass correlation coefficient >= 0.30) to create a composite performance score. The internal consistency reliability (Cronbach's alpha) of the composite score, created by combining the process and outcome measures with an intraclass correlation coefficient >= 0.30, exceeded 0.80. The standard errors of the composite case-mix adjusted score were sufficiently small to discriminate those physicians scoring in the highest from those scoring in the lowest quartiles of the quality of care distribution with no overlap. Conclusions: We conclude that the aggregation of well-tested quality measures that maximize the "physician effect" into a composite measure yields reliable physician-level quality of care scores for patients with diabetes.


Page:
378---387


Similar Literature

Submit Feedback

This function is a member function, members do not limit the number of downloads